Polls continue to show that more Americans are against Obamacare than for it. But these polls also demonstrate that voters want the pressing problems of the system fixed, just without the massive expansion of governmental power and spending contained in Obamacare. A market-based reform agenda could deliver much more positive results than a federally managed approach like Obamacare. Seven pillars that would support such an effective replacement program are: to build a “defined contribution” approach to the public financing of health care, encourage personal responsibility and mandate continuous coverage protection, establish a genuine partnership with the states, address the tax treatment of employer-sponsored plans, overhaul Medicaid, initiate premium-support reform of Medicare, and, finally, offset all new costs through spending cuts. If successful, this new program could permanently change the national political conversation over health care policy.